Foreign trained doctors in the U.S.

Among the 12.4 million workers employed in health-care occupations in 2015, 2.1 million (17%) were foreign born. The foreign born accounted for 28% of the 910,000 physicians and surgeons practicing in the United States, and 24% of the 2.1 million nursing, psychiatric, and home health aides (go here).

Physicians who were trained outside the U.S.

About 25% of practicing physicians are graduates of foreign medical schools. Of these upwards of a third are American citizens who obtained their medical degree from a foreign medical school. A recent study reports the “evidence suggests the care these physicians provide is as good as or better than that provided by graduates of US schools. They are substantially more likely to practice in rural and poorer communities and are overrepresented in primary care specialties, including family medicine and pediatrics. Shortages of US physicians are predicted to increase, both in primary care in certain specialties over the coming decades” (go here).

To gain access to practice in the U.S. foreign medical school graduates must pass tests by a gatekeeper special commission, and also enter residency programs, even if they have done them before. This is a major disincentive to immigrate. The Educational Commission for Foreign Medical Graduates (ECFMG) was created 60 years ago and “represents the interests of the organized medical profession.”

According to the Commission, of the roughly 10,000 certifications it gave in 2015, the last year reported, 30.9% of certificates were issued to U.S. citizens, and 18.9% were from India or Pakistan, and 7.9% from Canada. The American citizens appear to be educated in one of about six Caribbean islands, Grenada and Dominica being the largest.

Foreign medical school graduates have a very high percentage of practicing physicians in some state: New Jersey (40%), New York (38%), and Florida (35%).